Objective To learn the domestic investigation into pulmonary cryptococcosis in the 22 years.Methods We retrieved the literature about pulmonary cryptococcosis included in CMCC,and summarized the clinical data of 67 patients suffering from pulmonary cryptococcosis.Results The clinical situation and radiological manifestation of pulmonary cryptococcosis were diverse and nonspecific.Cryptococcal meningitis was the commonest complication(31.34%).Almost all patients with pulmonary cryptococcosis were once misdiagnosed.Final diagnosis mainly depended on the smear,culture or pathological examination of various clinical specimens.Therapeutic tool involved resection with operation and the application of anti-fungi drugs.Conclusion To increase the cognition to the disease is the key to increase the final diagnosis rate.Therapeutical effect of anti-fungi drugs should be emphasized,especially the application in preoperation and postoperation can decrease the dissemination of cryptococcus after operation,which might result in cryptococcal meningitis.

Objective: To evaluate the inhibition of human endostatin on tumor growth and metastasis of lung adenocarcinoma LA795 in mice. Methods: Recombinant human endostatin was purified from pCX expressed endostatin clones. Plasminogen was purified from outdated human plasma by affinity chromatography, and human angiostatin was produced from human plasminogen digested by elastase and purified by affinity chromatography. LA795 cells were inoculated subcutaneously into the dorsa of T739 mice, and the mice were randomized into 3 groups. From the 1Oth day, the first group was given 20 mg/kg of recombinant human endostatin s.c. qd, the second was treated daily s. c. of 7.5 mg/kg of human angiostatin, and the third group received daily s.c. with equal volumes of PBS for 14 days. Volumes of the subcutaneous tumors, lung weights, the number of lung surface metastases and mice life span were observed. The results were analyzed by q-test. Results: The tumor volumes of both the 1 st and the 2nd groups increased slowly. From the 8th day after being treated, the tumor volumes were decreasing. However, in the 3rd group, the tumor volumes increased continuously. The lung weight and the number of lung surface metastases of the 1st and 2nd groups were less than that of the 3rd group. The average survival periods of the 1st and 2nd groups were longer than that of the 3rd group. Conclusion: Human endostatin and angiostatin have strong inhibitory effects both on growth of primary tumor and metastasis of lung adenocarcinoma LA795, and prolongs the survival period of the tumor-bearing mice.

Objective To study the cerebral energy metabolism changes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) through hydrogen magnetic resonance spectroscopy examination (1 HMRS ) and its relationship with partial pressure of oxygen / carbon dioxide tension.Methods Totally 13 cases of AECOPD patients and 10 cases of age-matched healthy people underwent HMRS examination.The ratios of n-acetyl-aspartate(NAA)/creatine(Cr),choline (Cho)/Cr,myo-inositol(MI)/Cr of parieto-temporal and occipital areas of brain were detected.Blood gas analysis were also used to detect partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2).Results NAA / Cr of parieto-temporal and occipital areas of brain (1.32±0.12,1.48±0.12) were lower in AECOPD group than those in control group (1.45±0.11,1.58±0.10) (P＜ 0.05),MI/Cr (0.23±0.07,0.30±0.11) were also decreased compared with control group (0.40±0.14,0.46±0.12) (P＜ 0.01),while Cho/Cr of parieto -temporal and occipital areas of brain between the AECOPD group and control group showed no significant difference (P＞0.05).NAA/Cr of parieto temporal and occipital areas of brain were positively correlated with PaO2 (r=0.46 and 0.44),and MI/Cr of these areas of brain were also positively related with PaO2 (r=0.63 and 0.50),but MI / Cr of parieto tempora was negatively correlated with PaCO2 (r =- 0.472). Conclusions Cerebral metabolite changes may occur in AECOPD patients,and this has relationship with hypoxia and carbon dioxide retention.

Objective To improve the early diagnosis and prognosis factor of pancreatic carcinoma by summarizing and analyzing the clinical data. Methods The clinical data of 90 patients with pancreatic carcinoma of our hospital from 1989 to 2005 were analyzed retrospectively. Results The symptoms of pancreatic carcinoma were very complicated,the most common manifestations were bellyache,jaundice and weight loss. Main physical signs in these patients included abdominal tenderness,abdominal mass,hepatomegalia,gallbladder enlargement. Jaundice was the outstanding manifestation of pancreatic head cancer. Among all patients,16 cases accepted sugical resection(17.8%),and the 1-year,3-year,5-year survival rate were 22. 2%,11.1% and 2. 2% respectively. Our data showed that the most important prognostic factors which influenced life span were the surgical procedures,tumor size and location,histological differentiation,TNM stage. Conclusions Clinical manifestations of pancreatic carcinoma are related to TNM stage,tumor size and location,histology type,complication disease. Clinical symptoms only provide clue for diagnosis of pancreatic carcinoma. Laboratory and imaging examination will provide objective evidence for further diagnosis and prognosis in pancreatic carcinoma.

OBJECTIVE To understand the relevant factors of nosocomial infection of inpatients in order to provide the evidence for taking measures to prevent and control the infection effectively.METHODS A retrospective survey was carried out on 10059 cases of hospitalized patients during Jan and Dec of 2008.RESULTS The nosocomial infection rate of hospitalized patients in this period was 4.3%(437/10059).The high risk infected rates were respectively as follows:24.9% in the Blood Department,15.1 % in the Tumor Department;The infection site were respiratory tract(59.3%),urinary tract(14.3%);The main pathogens were Gram negative bacteria(40.7%),fungus infection(25.4%);The risk factors mainly were usage of antibiotic drugs(40.7%),and underlying diseases of tumor(16.2%).CONCLUSIONS The effective measures for reducing the incidence of nosocomial infection should be taken.More attention should be paid on the risk factors.

To analyze the clinical characteristics,imaging and pathological features of 1 case with partial right lung atelectasis and summarize the relevant domestic reports on the false positive of positron emission tomography-computed tomography (PET-CT) and tumor markers.The patient was diagnosed by PET-CT as partial atelectasis and there were progressive increases of CEA,CA199 and CA242.But site of lesion biopsy showed no malignancy.After treatments of anti-inflammatory and eliminating phlegm,the tumor markers returned to normal and the lesion site had excellent re-expansion.The detection of PET-CT plus tumor markers may have false positive probability.The reason is probably related with inflammation and glandular secretion of lesion site.

Objective To discuss the clinical value of new- utility anal vacuum tube in preventing anastomotic fistula after colorectal cancer anterior resection. Methods Ninety-six patients having underwent the colorectal cancer anterior resection were divided into new-utility anal vacuum tube group and normal anal vacuum tube group by random digits table method with 48 cases each. The complication, anus exhaust time and postoperative drainage volume were compared between 2 groups. Results The incidences of tube defluxion, proctalgia, anus skin damage, bed sheet pollution and anastomotic fistula in new-utility anal vacuum tube group were significantly lower than those in normal anal vacuum tube group: 6.25% (3/48) vs. 31.25% (15/48), 10.42% (5/48) vs. 41.67% (20/48), 0 vs. 25.00%(12/48), 6.25%(3/48) vs. 60.42%(29/48), 2.08%(1/48) vs. 12.50%(6/48), the anus exhaust time was significantly shorter than that in normal anal vacuum tube group:(44.1 ± 8.9) h vs. (48.9 ± 9.6) h, the postoperative drainage volumes form the first day to fifth day were significantly more than those in normal anal vacuum tube group: (31.2 ± 15.1) ml vs. (15.6 ± 8.2) ml, (25.3 ± 13.2) ml vs. (15.8 ± 6.5) ml, (15.6 ± 9.1) ml vs. (10.3 ± 4.5) ml, (104.3 ± 38.2) ml vs. (90.6 ± 12.3) ml and (93.7 ± 32.5) ml vs. (80.7 ± 18.9) ml, and there were statistical differences (P<0.01 or <0.05). The patients in new-utility anal vacuum tube group had different symptoms, but patients could tolerate. Conclusions The new-utility anal vacuum tube can reduce the incidence of anastomotic fistula, and be safe and reliable, which is worthy of wide application.

Objective To improve the understanding of pulmonary mucormycosis by analyzing the clinical manifestations,imaging features,diagnosis,treatment and prognosis of this disease.Methods The clinical data of eight patients diagnosed as pulmonary mucormycosis by histopathologic examination were retrospectively analyzed.Results Eight patients included six males and two females with age from 36 days to 66 years.Underlying conditions covered diabetes (n =4),renal transplantation (n =3),premature (n =1) and long-term corticosteroid treatment in two cases.Imaging manifestations revealed multiple irregular lumps or nodules in three cases,multiple cavities with thick wall in three cases,diffuse lung infiltrate in one case and lung opacities in one case.The diagnoses of seven patients were confirmed by percutaneous needle lung biopsy and the remaining one was diagnosed with fiberoptic bronchoscopy biopsy.Surgery combined with amphotericin B liposome(60 mg/d for three weeks)was applied to one patient who was cured with no recurrence after a 22 month follow-up.Three cases were given amphotericin B liposome (a newborn with 7mg/d for 62 days,the other two 60 mg/d for 31 days and 70 mg/d for 71 days respectively).All had achieved marked response with follow up from 8 to 29 months,but one patient relapsed and died of recurrent lung mucormycosis.The other three patients were treated with itraconazole 400-200 mg/d from 21 days to 1 year with duration of follow up from 1 month to 20 months.One patient was not evaluable due to missing.Two patients relapsed and one died.Conclusion Pulmonary mucormycosis is difficult to diagnose and treat with a high mortality.Percutaneous tranthoracic lung biopsy is a useful diagnostic method.Amphotericin B liposome or itraconazole may be active against mucus.Early control of causes is essential to improve the prognosis and reduce the recurrence in patients with pulmonary mucormycosis.

Objective To discover,diagnose and treat colorectal cancer in the early period and further improve the survival rate,reduce morbidity and mortality of the colorectal cancer by early screening for colorectal cancer in Jinjiang.Methods According to “The Guide of Cancer Screening and Early Diagnosis and Treatment in China by the Experts Group of Ministry of Health”,the case history was collected while the stool occult blood and FOBT were detected to discover high risk crowd who then inspected by electron enterscope.Results The screening was practiced in Xibin,Zimao and Neikeng town respectively.The crowd of 40-74 years old was 10 116 and 2631 of them accepted screening(acclimation rate,26％).Two hundred and fifty-seven high-risk people were discovered(9.8％ of 2631)and 86 of them(acclimation rate,33％,86/257)were inspected by electron enterscope.Twenty-two cases were detected with colorectal affection(detection rate,8.6％,22/257),20 cases were diagnosed as colorectal adenoma and 2 cases were diagnosed as adenocarcinoma by pathological section.All of them accepted therapy.Conclusion Carrying out early screening for colorectal cancer is important.It can reduce morbidity and mortality of the colorectal cancer and then improve the cure rate and prolong survival in patients with colorectal cancer.

Objective To screen the clinical factors affecting the malignant probability of solitary pulmonary nodule (SPN) with univariate and multivariate Logistic regression analysis,and to establish a clinical prediction model,evaluate its test effectiveness in the differential diagnosis in SPN.Methods A retrospective cohort study included 182 patients with diagnosis of SPN (group A).Clinical data included gender,age,smoking history,quitting smoking,history of tumor,serum carcinoembryonic antigen (CEA),location,diameter,density,vacuole sign,cavity,airbronchogram,calcifcation,lobulation,spiculate sign,spiculation,pleural indentation sign,vascular convergence sign,enhanced CT value,the maximum standard uptake value (SUV~x) of positron-emission tomography (PET),pathological diagnosis were collected.The independent predictors of malignancy were estimated with univariate and multivariate analysis,then the clinical prediction model to identify malignant was established.Other 45 SPN patients (group B) were used to tested value of the model.Results Univariate analysis showed that gender,age,no lower lobe location,diameter,density,airbronchogram,calcification,lobulation,spiculation,pleural indentation sign,enhanced CT value ≥ 15 HU,SUVm,≥ 2.5 of PET significantly affected judgment of SPN of benign or maligant (P ＜ 0.05).Multivariate analysis revealed that female,age,lobulation,short spiculation,pleural indentation sign was the independent predictors of malignancy in patient with SPN,solid nodule suggested benign.The clinical prediction model to identify malignant was established:P =ex/ (1 + ex),x =-3.399 +1.382 × gender + 0.056 × age + 1.377 × lobulation + 1.498 × spiculation-2.096 × solid + 1.005 × pleural indentation sign,e was natural logarithm.P =0.663 was as cut-off point,group B was used to test value of the model:the sensitivity was 86.5％,the specificity was 62.5％,the positive predictive value was 91.4％,the negative predictive value was 50.0％,the accuracy was 82.2％.Conclusions As for SPN,female,age,lobulation,short spiculation and pleural indentation sign is the independent predictor of malignancy in patient with SPN,solid nodule suggests benign.The prediction model is sufficient to estimate the malignancy of patient with SPN.